1.Perioperative Short Term Prophylaxis against Deep Vein Thrombosis after Major Abdominal Cancer Surgery: Retrospective Cohort Study
Nuray COLAPKULU-AKGUL ; Ibrahim Ali OZEMIR ; Damla BEYAZADAM ; Orhan ALIMOGLU
Vascular Specialist International 2021;37(4):45-
Purpose:
The aim of this study is to evaluate the outcomes of pharmacological thromboprophylaxis given for short-term duration to the patients who underwent major abdominal surgery for colorectal and gastric cancer.
Materials and Methods:
This retrospective cohort study was performed in consecutive patients who underwent major abdominal surgery for colorectal and gastric cancer and received short-term pharmacological thromboprophylaxis during hospital stay were enrolled. Complete duplex ultrasonography of the lower limbs was performed for all patients to investigate both symptomatic and asymptomatic deep vein thrombosis (DVT).
Results:
Overall, 278 patients were evaluated for inclusion and 62 colorectal and 27 gastric cancer patients were enrolled. Of 89 patients, the incidence of total and symptomatic DVT was 4.5% and 2.2%, respectively. The patients with symptomatic DVT were diagnosed within the first four months. The incidence of coronary artery disease, mucinous adenocarcinoma and vascular tumor invasion were significantly higher in patients with DVT (P-values<0.001, 0.009, and 0.02, respectively).
Conclusion
Short-term pharmacological thromboprophylaxis after major abdominal surgery for colorectal and gastric cancer does not increase symptomatic DVT rates of patients with low Caprini score. Postoperative DVT surveillance may benefit patients with coronary artery disease, mucinous adenocarcinoma or vascular invasion of the tumor.
2.Surgical indicators for the operative treatment of acute mechanical intestinal obstruction due to adhesions.
Tunc EREN ; Salih BOLUK ; Baris BAYRAKTAR ; Ibrahim Ali OZEMIR ; Sumeyra YILDIRIM BOLUK ; Ercument TOMBALAK ; Orhan ALIMOGLU
Annals of Surgical Treatment and Research 2015;88(6):325-333
PURPOSE: Our aim was to investigate the predictive factors indicating strangulation, and the requirement for surgery in patients with acute mechanical intestinal obstruction due to adhesions. METHODS: This study retrospectively evaluated the records of patients with adhesive acute mechanical intestinal obstruction. The surgical treatment (group S), conservative treatment (group C), intraoperative bowel ischemia (group I), and intraoperative adhesion only (group A) groups were statistically evaluated according to the diagnostic and surgical parameters. RESULTS: The study group of 252 patients consisted of 113 women (44.8%), and 139 men (55.2%). The mean age was 62.79 +/- 18.08 years (range, 20-98 years). Group S consisted of 50 patients (19.8%), and 202 (80.2%) were in group C. Group I consisted of 19 patients (38%), where as 31 (62%) were in group A. In group S, the prehospital symptomatic period was longer, incidence of fever was increased, and elevated CRP levels were significant (P < 0.05). Plain abdominal radiography, and abdominal computerized tomography were significantly sensitive for strangulation (P < 0.05). The elderly were more prone to strangulation (P < 0.05). Fever, rebound tendernes, and urea & creatinine levels were significantly higher in the presence of strangulation (P < 0.05, P < 0.05, and P < 0.05, consecutively). CONCLUSION: Fever, rebound tenderness, urea & creatinine levels, plain abdominal radiography, and abdominal computerized tomography images were important indicators of bowel ischemia. Longer prehospital symptomatic period was related with a tendency for surgical treatment, and the elderly were more prone to strangulation. CRP detection was considered to be useful for the decision of surgery, but not significantly predictive for strangulation.
Adhesives
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Aged
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Creatinine
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Female
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Fever
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Humans
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Incidence
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Intestinal Obstruction*
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Ischemia
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Male
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Radiography, Abdominal
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Retrospective Studies
;
Tissue Adhesions
;
Urea